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Field Reports

April 6, 2018
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The 15-Year Effort to Eliminate Lymphatic Filariasis in Thailand

Reporter’s Profile
Chanchai Wongcharoen
Eisai (Thailand) Marketing Co., Ltd.

In September 2017, Thailand was certified by the World Health Organization (WHO) as having eliminated lymphatic filariasis (LF) as a public health problem. The Bureau of Vector Borne Disease under the Ministry of Health started the LF Mass Drug Administration (MDA) program in 2002, and 11 endemic provinces had achieved LF elimination in 2013. After another four years of monitoring and assessment in accordance with WHO guidelines, Thailand finally passed the criteria for elimination in 2017.

Dr. Tedros Adhanom (Director General of WHO, on the right) and Dr. Poonam Khetrapal Singh (Regional Director for South-East Asia WHO, on the left) are handing the elimination certification to Dr. Thawat Suntrajarn (Vice Minister of Public Health)
(Photo provided by Ministry of Health)

The Bureau of Vector Borne Disease gave an interview to Eisai (Thailand) Marketing Co., Ltd., Eisai’s subsidiary in Thailand, on the 15-year effort to eliminate LF in Thailand.
A population of 150,000 people in 357 LF endemic units in 11 provinces received the MDA program with diethylcarbamazine citrate (DEC) plus albendazole once a year for at least five consecutive years. By means of implementing “Filarial Week” in April every year from 2002, MDA were conducted no matter whether it was expanding smoothly or whether there were any issues being faced. However, the unrest in the southern provinces of Thailand, particularly in Narathiwat in 2004 seriously impeded the progress of LF elimination. The insurgents waged an insurrection with a string of daily bombings until the project officers were too scared to access the endemic areas. As a result, in the last insurrection province (last endemic province), instead of 5 rounds, it took the authorities 11 rounds of MDA which lasted about 10 years. The MDA in those areas were successful in reducing the number of newly infected people through trained healthcare volunteers, who are trained by the provincial public health unit to provide MDA to local people. For example, although MDA took place every year in Narathiwat, the program coverage was quite low. With healthcare volunteers’ assistance, the coverage went up and the program became successful. The healthcare volunteers for Narathiwat played a key role during not only the MDA implementation, but also evaluation by taking the blood tests of infected people during the MDA until the overall incidence rate went down to the lowest. Currently, there remains only 20 LF cases in Narathiwat and the patients have been treated in accordance with the WHO guidelines. Furthermore, pets are also randomly checked for infection regularly, in which case the infected are also treated.

Training for healthcare volunteers and preparation of MDA
(Photo provided by Ministry of Health)
MDA conducted in 2006
(Photo provided by Ministry of Health)

Although Thailand had achieved a low endemic rate of LF, the intense movements of cross-border Myanmar migrant workers to Thailand bring the risk of infection. Thailand is continuously conducting surveys and dispensing LF treatments to Myanmar laborers to prevent transmission again.

Special thanks to Dr. Preecha Prempree, Director of Bureau of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, and Ms. Sunsanee Rojanapanus, Senior Technical Health Officer and LF Program Manager, Ministry of Public Health, who gave the interview to Eisai (Thailand) Marketing Co., Ltd.

 
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